This report examines the U.S. preparations process for WARC-92, highlighting efforts to integrate the needs and concerns of various interest groups. It also reviews the forces and trends affecting the United States as it approaches WARC-92, and is intended to inform future congressional oversight of the domestic and international radio communication policy process.
This background paper, OTA sought information and advice from a broad spectrum of knowledgeable individuals and organizations whose contributions are gratefully acknowledged. As with all OTA studies, the content of this background paper is the sole responsibility of the Office of Technology Assessment and does not necessarily represent the views of our advisers and reviewers.
This report examines the health insurance status of adolescents (10 to 18 years of age) based on census data. It considers the reasons that some adolescents are insured and others are not, changes in the number of uninsured adolescents over time, and the effects of various approaches to ensure that more adolescents have insurance.
Adult education needs are difficult to define and difficult to meet; what constitutes adequate literacy changes continually as the demands facing individuals grow more complex. This report is an attempt to identify those capabilities, along with limitations, and outline how new information technologies can be marshaled to meet the goal of a fully literate citizenry.
This background paper analyzes technologies for tomorrow’s information superhighways. Advanced networks will first be used to support scientists in their work, linking researchers to supercomputers, databases, and scientific instruments. The paper also describes six test networks that are being funded as part of the High Performance Computing and Communications Program.
The purpose of this background paper is to describe the current state of development of HIV vaccines, and to discuss what is known about adverse reactions that may occur. The background paper provides an overview of ethical issues that arise in the conduct of HIV vaccine trials. The report also discusses alternatives to the current product liability system to encourage the development of HIV vaccines and to fairly compensate those who are harmed as a result of adverse reactions to the vaccine.
This background paper examines several proposals for reducing the costs of spacecraft and other payloads and describes launch systems for implementing them. It is one of a series of products of a broad assessment of space transportation technologies undertaken by OTA at the request of the Senate Committee on Commerce, Science, and Transportation, and the House Committee on Science, Space, and Technology.
This background paper focuses on one technological option for increasing the supply of fresh water to the Southwest-that of building a freshwater subsea pipeline to transport water from Alaska to California. Originally a suggestion by Governor Walter Hickel of Alaska, the proposal has recently attracted attention in southern California.
This background paper outlines some of the issues of importance for making choices about the future nature and role of U.S. armed forces, and suggests how these choices will affect defense base requirements. The final report of the assessment, to be delivered in the spring of 1992, will address specific policy options arising from the strategic choices and tactical decisions discussed here.
This background paper presents the results of a study of physician and sperm bank practice of artificial insemination in the United States. It documents the number of women undergoing artificial insemination each year, the annual cost, medical and social screening criteria for women seeking artificial insemination and men who donate semen, the genealogical recordkeeping available to the resulting children, and physician attitudes toward possible changes in artificial insemination practice.
This paper examines the health services and economics literature to learn what is known about the effects of patient cost-sharing (that is, annual deductibles, coinsurance, copayments, and out-of-pocket maximurns) on patients’ use of health care services, on plan expenditures, and on patients’ health outcomes.
A report on High Definition Television (HDTV. During 1989, HDTV moved from obscurity to center stage in the ongoing debate over the role of the Federal Government in U.S. industrial competitiveness. HDTV and related High-Resolution System (HRS) technologies in the computer and communications sectors may significantly impact U.S. electronics manufacturing, accelerate fundamental restructuring of the U.S. communications infrastructure, and provide a host of valuable services.
This paper describes biological contributing factors to substance abuse and addiction. The second document being produced by this study will discuss the complex interactions of biochemical, physiological, psychological, and sociological factors leading to substance abuse and addiction.
This background report responds to a request by the Subcommittee on Water and Power Resources of the House Committee on Interior and Insular Affairs. The subcommittee asked that OTA review the health effects of high-voltage transmission lines. To provide background information for its assessment on electric power wheeling, OTA contracted with the Carnegie-Mellon University.
This report reviews the history of four Federal bioethics initiatives: the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the Ethics Advisory Board, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, and the Biomedical Ethics Advisory Committee.
This report discusses a study that provides a basic introduction to biopolymer technology; profiles some of the more promising polymer materials; reviews research activities in the United States, Europe, and Japan; and describes the principal technical challenges and regulatory issues that may affect biopolymer commercialization efforts.
This OTA background paper evaluates the current state of knowledge and assesses the potential of bioremediation for responding to marine oil spills. Our basic message is a dual one: we caution that there are still many uncertainties about the use of bioremediation as a practical oil spill response technology; nevertheless, it could be appropriate in certain circumstances, and further research and development of bioremediation technologies could lead to enhancing the Nation’s capability to fight marine oil spills.
The report discusses the oral health of children eligible for Medicaid, the House Committee on Energy and Commerce and its Subcommittee on Health and the Environment requested OTA to determine whether children eligible for Medicaid are provided at least a minimum level of dental care. This study compares the dental manuals of seven State Medicaid programs with a set of “basic’ dental services (which comprise shared components of various well-accepted dental guidelines) to see if States allow these particular services.
This report reviews technologies available for hazardous waste cleanup at wood-treating sites throughout the United States. OTA found that there are many Superfund wood-treatment sites located in this country that are very similar in terms of the contaminants present and the options selected for cleanup.
This paper seeks to place the issue of climate change within an international context. Specifically, it addresses the feasibility of forging treaty agreements among countries to achieve significant worldwide reductions in emissions of greenhouse gases.
This background paper examines existing intellectual-property protection for computer software-copyrights, patents, and trade secrets—and provides an overview of the often conflicting views and concerns of various stakeholders. It was prepared in response to a request from the Subcommittee on Courts, Intellectual Property, and the Administration of Justice of the House Committee on the Judiciary.
In the aftermath of the Exxon Valdez oil spill in Alaska in March, 1989, a myriad of investigations were initiated to evaluate the causes of that accident and to propose remedies. The Office of Technology Assessment was asked to study the Nation’s oil spill clean-up capabilities and to assess the technologies for responding to such catastrophic spills in the future.
This paper describes briefly the work on DoD’s Kuwait Oil Fire Health Risk Assessment to date, including the results of a pilot study of health risks, and then answers the questions addressed to OTA in PL 102-585.
This background paper provides an overview of developing country environmental problems and markets for environmental technologies and services. It discusses preliminary estimates on the amount and purposes of environmental aid provided by donor countries in 1991. The paper discusses the commercial implications of other countries’ aid for U.S. environmental firms, and the Helsinki package adopted by the OECD in late 1991 to limit commercial advantage from use of tied aid credits.
This paper presents the status of national efforts to cleanup dioxin-contaminated sites and the technologies that have been used, proposed, and researched. It covers thermal and nonthermal treatment techniques as well as approaches such as stabilization and storage. It discusses the development of these technologies as well as advantages and disadvantages of their use.
This background paper briefly describes the Army’s chemical weapons destruction program, discusses the factors that could affect a decision to develop alternatives, discusses the alternatives, and illustrates the difficulty of gaining public acceptance of complex technical systems.
This paper assesses the medical benefits and costs of both screening and hormone replacement therapy. It is divided into two volumes. This volume presents the results of a model that estimates the cost per year of life gained from osteoporosis screening and hormone replacement therapy in postmenopausal women.
This paper assesses the medical benefits and costs of both screening and hormone replacement therapy. It is divided into two volumes. This volume provides the basis for the assumptions about the costs and effects of screening and hormonal replacement therapy used in the cost-effectiveness model.
This background paper discusses the technological options available for use in an electronic system to deliver public assistance benefits, the privacy and security implications of such a system, and the programmatic effects of changing to an electronic delivery system. It was requested by the Subcommittee on the Handicapped of the Senate Committee on Labor and Human Resources.
The background paper extends the analysis of energy use into new areas by explicitly looking at how energy use has changed with the expansion of the service sector, the explosion of international trade, and greater complexity of the U.S. economy as the structure of businesses changed in response to new technologies and competitive challenges. The increasing sophistication of the U.S. economy means that the role of energy is less likely to be directly identified and is instead more likely to be an indirect factor that was added many steps before in the complex network that connects producer to consumer. This report explicitly separates direct from indirect energy use.
This report focuses on key assumptions that will affect the sizing and procurement of the new FBI system, and on other related steps that appear necessary to ensure complete and up-to-date record systems. These include full implementation of a Federal/State/local partnership for maintaining and exchanging fingerprint and criminal history records; enactment of an interstate compact or Federal legislation setting out uniform rules for the exchange of such records; standards and funding for improving criminal history record completeness and disposition reporting; and privacy and security protections for electronic fingerprint and record information.
This background paper describes the development of alglucerase, illustrates the role that both the Federal Government and private sector can have in making new therapies available for orphan diseases, and lays out some of the tradeoffs that can exist between developing new medical technologies and controlling health care costs.
This report analyzes universities’, companies’, and researchers’ experiences and perspectives since enactment of federal laws to enhance technology transfer—especially as it pertains to research funded by the National Institutes of Health and the Department of Energy, the agencies funding U.S. efforts in the Human Genome Project.
This report focuses on the following two questions for the U.S. fusion energy program. First, what is the role of the Tokamak Physics Experiment (TPX), an approximately $700 million fusion reactor currently awaiting a congressional decision to begin construction? Second, what is the role of alternatives to the tokamak concept in a broad-based fusion energy program?
This paper presents results from a 1991 OTA survey of 431 genetic counselors and nurse geneticists. It was conducted to better understand the environment in which the average genetic counselor or nurse in genetics works, to describe the infrastructure and tools available to these professionals, to assess the state of practice in the provision of cystic fibrosis (CF) carrier screening, and to evaluate their attitudes regarding CF carrier screening.
This background paper describes results from a 1991 OTA survey of U.S. health insurers’ attitudes toward genetic tests and genetic information— both how they currently view information from various sources (e.g., genetic tests, other medical tests, or family histories) in underwriting decisions and how they might reimburse consumers for genetic tests. It also reports data on the role health insurers expect genetic tests and genetic information will play in their business practices over the coming decade.
This paper concludes that, thus far, Department of Energy has (DOE) and its contractors have devoted little attention to cleanup worker health and safety. They have not convinced workers and managers that a “new culture” of accountability in environment, safety, and health is truly ascendent.
This paper discusses the experiences of Australia, Canada, France, Germany, the Netherlands, Sweden, and the United Kingdom—technology assessment with six technologies (or sets of technologies) including evaluation and management efforts and how the technologies diffused— are presented and compared.
The focus of this paper is the history of Department of Defense (DoD) Federally Funded Research and Development Centers (FFRDCs) over the past 50 years, which forms part of the Office of Technology Assessment (OTA) study of defense modeling and simulation.
This report discusses a seven-country study of hospital financing is an attempt to find lessons for the United States. The individual experiences over the past decade of the United States and six of its international peers—Canada, England, France, Germany, the Netherlands, and Sweden—in hospital financing and payment systems are reviewed by experts in each country.
This background paper, which describes the state-of the- art of identifying substances that can harm the immune system, represents one response to the committee’s request. Chapter 2 provides basic information about the principal components of the immune system and the general consequences that stem from perturbations to it. Chapter 3 describes methods for evaluating chemical immunotoxicity and reports on some known or suspected immunotoxicants. Chapter 4 summarizes Federal research and regulatory activities related to immunotoxicity.
This Background Paper examines whether the agencies responsible for administering Federal environmental and health and safety laws have taken this concern for respiratory health to heart. This paper provides a partial response to the committees’ request for an assessment of noncancer health risks in the environment and follows OTA’s previous work on carcinogenic, neurotoxic, and immunotoxic substances.
This report discusses the indirect cost of medical malpractice, commonly referred to as “defensive medicine,” that may add to overall health care costs. The cost of defensive medicine remains unknown and is subject to much speculation because there are no sound empirical data.
In June 1995, OTA convened a workshop that brought together some of the world’s leading practitioners, academic experts, experienced diplomats, and leading technologists in order to study and discuss this issue. This report contains a summary of the results of the workshop, along with the original papers presented.
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